ERCP在胆囊切除术后胆总管结石治疗中的应用

Application of ERCP in treatment of common bile duct stones after cholecystectomy

目的探讨ERCP在胆囊切除术后胆总管结石治疗中的应用价值。方法回顾性分析2011年1月至2021年4月在中山大学附属第三医院首次行ERCP治疗的76例胆囊切除术后胆总管结石患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男46例,女30例;平均年龄(61±13)岁。观察患者ERCP治疗情况、并发症发生情况及疗效。结果74例患者均顺利完成ERCP,2例患者取石失败,取石成功率97%(74/76)。手术时间(98±60)min。术后住院时间2~18 d,中位住院时间5 d。6例患者术后发生并发症,发生率8%(6/76),其中2例术后轻型胰腺炎,4例感染,均保守治疗后治愈。5例患者术后结石复发,反复行ERCP治疗,复发率7%(5/74)。结论对于胆囊切除术后胆总管结石患者,ERCP是一种创伤小、安全、有效的治疗方法,可作为非手术治疗的首选方法。

Objective To evaluate the application value of endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of common bile duct stones after cholecystectomy.Methods Clinical data of 76 patients with common bile duct stones after cholecystectomy who received initial ERCP in the Third Affiliated Hospital of Sun Yat-sen University from January 2011 to April 2021 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,46 patients were male and 30 female,aged(61±13)years on average.ERCP treatment,complications and clinical effects were observed.Results ERCP in all 74 patients were completed successfully,whereas stone removal failed in 2 cases.The success rate of stone removal was 97%(74/76).The operation time was(98±60)min.The length of postoperative hospital stay was 2-18 d,with a median 5 d.Postoperative complications occurred in 6 cases with an incidence rate of 8%(6/76).Among them,2 cases developed mild pancreatitis and 4 cases of infection,and all were cured after conservative treatments.5 patients presented with postoperative recurrence of stones and received repeated ERCP treatment.The stone recurrence rate was 7%(5/74).Conclusions ERCP is a minimally invasive,safe and effective method for patients with common bile duct stones after cholecystectomy,which can be considered as the primary option of non-surgical treatments.